Provider Demographics
NPI:1881261774
Name:RURAL FAMILY PHYSICIANS
Entity type:Organization
Organization Name:RURAL FAMILY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF RURAL FAMILY PHYSICIANS
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:WANDSNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:815-988-6351
Mailing Address - Street 1:3435 WYANDOT ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3353
Mailing Address - Country:US
Mailing Address - Phone:815-988-6351
Mailing Address - Fax:
Practice Address - Street 1:3435 WYANDOT ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3353
Practice Address - Country:US
Practice Address - Phone:815-988-6351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC0050XAmbulatory Health Care FacilitiesClinic/CenterCritical Access Hospital